There was a new diagnosis, and it was Boss Zheng's diagnosis. Everyone paid more attention to it. In addition, the spinal surgery department also requested an MRI. Chief Mao was carried into the MRI room in the shortest time possible.
"Boss, how did you think of endometriosis?" Su Yun looked at the MRI image and confirmed that Zheng Ren was right.
Because of this, he was even more surprised and asked.
"Call Lil Fugui. Let him bring Old Liu for today's surgery." Zheng Ren suddenly remembered that he still had a lot of things to do. "Call Brother Yang again and say that I have something on my side. The patient with liver cancer interventional embolization will be delayed a little."
"Everyone in the hospital knows that something happened. The surgery will definitely be delayed. I'm asking you, how did you diagnose endometriosis? "Su Yun asked again.
"It's not difficult. It's just that I can't determine the image of blood coagulation and coagulation." After looking at the MRI, Zheng Ren confirmed his thoughts and let out a long breath.
"Using CT to determine? Who are you lying to? "Su Yun said disdainfully as he relaxed a lot.
"CT can only be guessed. We need MRI. But it's enough to provide a reason for a guess. Look at how sufficient my reason is, "Zheng Ren said with a smile. Then, he stood up." Let's go for the surgery. "
"Seriously, how did you determine it?"
"Three years ago, a similar case occurred in a prefecture-level hospital in the south. The patient's family was very fierce and wanted to compensate 10 million yuan. In the end, the spinal surgery department confirmed that it was endometriosis and the matter was left unsettled, "Zheng Ren said. (Note)
"Why don't I remember it?" Su Yun was surprised.
"I didn't report it. I saw the case report in a Chinese journal a year ago. At that time, I was just thinking about it. Previously, when we looked at the radiographic films in the CT room, it didn't seem right no matter how we looked at it, so we looked for similar cases to compare, "Zheng Ren said with a smile.
"Are you confident in the surgery?"
"Yes," Zheng Ren said.
"Your confidence is really touching," Su Yun said expressionlessly.
"It's just a small piece of endometrium. Be careful not to break your gloves when you peel it off. Once it's broken and you make a small cut, the endometrium will appear on your finger … "
"It's so f * cking disgusting. Don't say it." Su Yun was stunned for a moment and stopped in his tracks.
When he thought about how his fingers would hurt and bleed during Chief Mao's period, Su Yun felt that he was not good.
"What are you thinking about?"
"Boss, you said that endometriosis can be contagious. Why isn't there a rejection reaction?" Su Yun asked.
"…" This guy's brain was really weird.
However, what he said seemed to be correct. The surgery for organ transplantation was not that difficult. The difficult part was the rejection after the surgery.
There are not many cases of endometrium implantation in other people, but there are definitely cases.
Zheng Ren was also stunned. This seemed to be a research direction for organ transplantation!
1.36 seconds later, Zheng Ren smiled and said, "Focus on the surgery. This is a spinal surgery."
"Are you good enough?"
"As your boss, I must be perfect in all aspects."
"Tsk."
The two of them walked into the operating room as they talked.
"Have you ever seen a thoracic spine surgery?" Zheng Ren asked.
"I've seen it twice. Why?"
"You'll get it after seeing it once. That's what you said. Don't fall behind when it's time to support the stage, "Zheng Ren said lightly.
"Boss, don't give me too much pressure. I'm at most the third assistant, and you're just the first assistant, "Su Yun said disdainfully.
Zheng Ren shook his head slightly.
In the operating room, Zheng Ren saw Chief Mao unconscious and lying on the operating table while Chief Xu intubated the trachea.
A professor from the orthopedics department was waiting by the side. After the anesthesia was over, they had to adjust their positions.
Zheng Ren crossed his arms and looked at the scans. Then, he went to the System's operating room and began his surgical training.
Orthopedics had used a Legend level skill book for hip replacement surgery in Nanyang, so Zheng Ren was not in a hurry.
It was only thoracic spine surgery …
…
After 15 ′ 22 ″, preoperative preparations were complete.
Chief Mao was in a prone position, maintaining the physiological forward curve of his lumbar spine. The orthopedics department professor personally disinfected the operating area and covered it with sterile towels.
After brushing his hands, disinfecting and putting on his clothes, Zheng Ren and Chief Xu of the spinal surgery department came to the operating table.
"Boss Zheng, you're here," Chief Xu said politely.
"Chief Xu, I'm just here to help you," Zheng Ren said with a smile.
"Don't mention it. Dr. Richard from Massachusetts General Hospital. He recommended you to become a tenured professor there, right? " Chief Xu smiled and said, "I'm a PhD student at Massachusetts General Hospital. Richard is slightly older than me, so he's my senior."
It was common in small hospitals to randomly recognize each other as brothers and sisters.
However, in the 912, everyone relied on their status. Very few people said that.
However, that was with the doctors in the country. Chief Xu had climbed up the 'high branch'. Anyway, Dr. Richard did not know if it was true.
Zheng Ren smiled. "I thought Dr. Richard was joking, but I didn't expect it to be true."
"I asked around and said that your hip replacement surgery was very good. It was also Dr. Su who gave you the table. Today, I'm just here to help and learn. "
The two of them had already put on their clothes. Under Chief Xu's insistence, Zheng Ren stood in the surgeon's position.
"Dr. Su, I'm standing in the position of the first assistant, not the first assistant." Chief Xu smiled and said, "You have to focus."
Su Yun was stunned for a moment and nodded.
"Microscope," Zheng Ren said in a deep voice before he opened the skin.
An anesthesiologist who was helping Chief Xu quickly put on the microscope for Zheng Ren, and the surgery officially began.
He reached out and gently patted the lancet in his palm.
A longitudinal incision was made with the eight and nine vertebrae as the center, about six centimeters long.
The skin, subcutaneous tissue, and deep fascia were cut open, and the blunt dissection began. The erector spinae muscles were separated along both sides of the spinous process, and the soft tissue on the eight and nine vertebrae and the transverse process was cleaned.
Generally speaking, the erector spinae muscles had to be cut open, but in order to reduce bleeding, Zheng Ren used the blunt dissection mode. The advantage of doing this was that there was less bleeding, but there were also many disadvantages.
He removed the lower articular process of the eight and nine vertebrae and exposed the origin of the ribs on both sides.
The intercostal veins and nerves of the corresponding ribs were separated and ligated.
The surgery was done cleanly and neatly, including the position of the articular process. Zheng Ren did not bite off all of it. It was enough to just expose the surgical field.
The damage was as small as possible, and the recovery after the surgery was also fast.
"Pay attention to the pleura," Zheng Ren said after ligating the intercostal veins and nerves and protecting the intercostal artery.
He stretched out his hand and the heavy rib forceps fell on his hand.
Zheng Ren used the rib forceps to cut off the ribs about three centimeters outside the rib joint and removed the ribs from the truncation point to the rib joint.
Then, Zheng Ren bit off all the pedicles and upper articular processes of the eight and nine vertebrae of the thoracic vertebrae, exposing the spinal cord.
Due to the bone removal, the bone stump bled continuously and the surgical field was a little blurry.
Su Yun sucked the blood with an aspirator while dipping the gauze in the blood. Less than a second after exposing the surgical field, the surgical field would be covered in blood again.
…
…
Note: This is the reason for looking for endometriosis in the beginning. I can't say which hospital it was from like when I first opened the book. Please forgive me. When I wrote this case report, I felt a lingering fear. It was useless to be cautious. To be a doctor, one had to have a good life.
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